September 2021 Pharmacy Policy Updates

Blue Cross Blue Shield of North Dakota (BCBSND) regularly develops and revises pharmacy policies in response to rapidly changing pharmaceutical requirements. Our commitment is to update the provider community as policies are adopted and/or revised. Benefit determinations are made based on the policy in effect at the time of service.

The following pharmacy policies were reviewed by the Internal Medical Policy Committee on Sept. 21, 2021, and will be updated within the next 30-45 days on our website.

Pharmacy Policies

The following medical drug policies are new and require precertification effective 10/1/2021:

The following medical drug policy is new effective 10/1/2021:

The following medical drug policy will require precertification effective 11/1/2021:

The following medical drug policies were revised:

The following medical drug policies had coding changes effective 10/1/2021:

The following medical drug policies were reviewed with no clinical content change:

The following new Utilization Management program was effective on the NetResults Formulary 9/1/2021:

  • Verquvo Prior Authorization/Quantity Limit Program